Jan Riordan, RN, MSN, EdD,
IBCLC, and La Leche League Leader, started her session by stating something
that has become obvious to many lactation consultants, hospital staff
workers, and La Leche League Leaders. These days, babies seem to be
having more trouble with early suckling, latching on to the breast,
disorganized suckling, and sleepiness in the first days of life. She
then discussed what the research says about the connection between breastfeeding
and epidurals.

Dr. Riordan gave a brief
history of pain relief during childbirth. Unmedicated birth resulted
in babies who generally suckled early and well. With the beginning of
medicated births where mothers were unconscious or had no memory of
the birth, problems with breastfeeding and other postpartum difficulties
became common. These were severe enough that unmedicated childbirth
became more popular by the early 80s. As epidurals became common, natural
childbirth lost ground. We watched a hospital video in which epidural
anesthesia was depicted as a pain-free, mostly risk-free way of managing
labor and birth that would not affect the baby. Riordan noted that side
effects and problems with epidurals are often minimized in materials
used to educate expectant mothers.

Riordan's presentation looked
at several studies showing the effects of medicated births on mother
and baby. The effects included a drop in some mothers' blood pressure,
head or backaches after delivery, prolonged second stage of labor, increased
rate of cesareans births, more instrument-assisted deliveries, and more
common fetal distress. Mothers also develop fevers after birth that
may be mistaken for infection and lead to separation of mother and baby.

Most of the research didn't
study problems with breastfeeding associated with epidurals, so Riordan
developed a study to focus on epidural anesthesia 's effect on the baby's
suckling and the duration of breastfeeding. She explained the methodology
of her study and its results. It clearly showed that medication during
birth did negatively affect babies' suckling during the first 12 hours,
and that combining medications increased the effect. Demerol was especially
harmful to the baby's suckling ability. The duration of breastfeeding
was not shown to be affected.

Riordan concluded that health
care providers and childbirth educators should inform expectant mothers
that diminished suckling is a risk of using pain medications during
childbirth. Currently, these risks are frequently glossed over.